Download - Oncology - Breast Ca
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2006 . 50292
2006 . 22670
2001 2006 . 11,1%
.., .., 2004
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Clinical Oncology 3rd edition. 2004
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BRCA1\BRCA2
TP53
1,5-9
60-80%
30-40%
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16
50
1,2
1,5
2,0
4,3 %
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,
10
, ,
1,3-1,6
1,2
1
1,1-1,4
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IGF-1
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39,0
13,0
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:
-
-
-
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: ,,
..
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- FNA, Core-, , - ( )
:- Rg - -
:- Rg- - , , - - -153-
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TNMT
0
isin situ
Tis (DCIS)in situ
Tis (LCIS)in situ
Tis (Paget`s)
T12T1 mic0,1
T1a - >0,1 , 0,5 , 1 , 2 , 5T4 ()
(b)
T4a
T4b ( ),
,
T4c
, T4a
T4b
T4d
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TNMN
Nx(
)
N0
N1
N2,
N2a,
.
N2b
N3
,
N3a
N3b
N3c
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TNM
M
0M1
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0 TisN0M0 (in situ)
I T1N0M0 ,
IIA 0N1M0
T1N1M0
T2N0M0
2-5
,
( )
II B T2N1M0
T3N0M0
2-5 ( T3N0M0)
,
(
) ( T3N0M0)
III A T0N2M0
T1N2M0T2N2M0
T3N1M0
T3N2M0
- ,
5
( T1-3N2M0)
( T3N1M0)
III B T4N0M0
T4N1M0
T4N2M0
III C T N3M0 ,
IV T N M1
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N
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(>35 )
( )
(ER, PR)( )
(G1-3)
HER2\neu
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+\-
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4 , T4
\
/ (, )
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T4
HER2/neu
(>35 )
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AC, CAF, FEC-
, , -
6 21-28
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( )
- (, , LH-RH ())
-
-
-
2-3 , 5 , 3
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T4
(>35 )
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, ,
-
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(, ) (
) (
) ( )
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()
40
30%
, ,
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()
ER:ERRAR:RXR
PG E2
AA
Ras, Raf
PI3K
MAPK, JNK,p38, AKT
2
RA
SERMs
E2
EGFHRG
-
P.Brown, 2004
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(SERM)
IBIS-I
7000
20
/
5
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BCTP (), MORE(), IBIS-I ():
- SERM 32 74%-
-
(NSABP P-2 STAR)- (, )
-
(SERM)
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(AI)
3-
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(AI)
ATAC (Arimidex, Tamoxifen Alone or in Combination)
I II
+/- +/-
1 /
+
3125
14
+ 20 /3115
33
1 /
+ 20 /3125
28
ATAC trialists, 2002
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(AI)
AI ER+
(ATAC BIG 1-98() ( )
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(AI)
IBIS-2 MAP-3
6000
4500
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(AI)
LCIS
SERM STAR 5
+
5
2,5 5
+SERM
5
NSABP P-4
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OX-2 ()
, , 1
OX-2 DCIS2
COX-2 ER+
ER- 3
1. Howe LR, et al. Cancer Res. 2002, 62:5405-5407
2. Shim V, et al. Cancer Res. 2003, 63:2347-2350
3. Harris RE, et al. Cancer Res. 2000, 60:2101-2103
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OX-2 ()
-
-
, PGE2
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OX-2 ()
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( )
Veronesi U et al. J Natl Cancer Inst Vol. 91, No. 21, 1847-1856, 1999
http://www.jncicancerspectrum.oxfordjournals.org/sub-journals/jnci/html/content/vol91/issue21/images/large/5f3.jpeg -
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(RXR)In vitro:
ER+ ER-
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GPx
Hu YL, Diamond A.Cancer Research 63, 3347-3351, June 15, 2003
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